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According to the ACA, this is not legal.* "A reasonable alternative standard must be provided to all individuals who do not meet the initial standard." For Employers: If you are charging tobacco users more than non-tobacco users, make sure you understand the ACA rules and offer a reasonable alternative standard

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While there is an upfront cost for the physician evaluation, this investment is often quickly recouped through tax savings, especially for regular users

When Kate first got sober at 18, she decided to quit smoking cigarettes, having regularly smoked since she was 16